Vol 28, No 6 (2021)
Original Article
Published online: 2021-12-17

open access

Page views 6323
Article views/downloads 752
Get Citation

Connect on Social Media

Connect on Social Media

Impact of COVID-19 on in-hospital cardiac arrest outcomes: An updated meta-analysis

Karol Bielski12, Katarzyna Makowska3, Adam Makowski3, Tomasz Kopiec3, Aleksandra Gasecka3, Mariola Malecka4, Michal Pruc5, Zubaid Rafique6, Frank W. Peacock6, Andrea Denegri7, Lukasz Szarpak58
Pubmed: 34985120
Cardiol J 2021;28(6):816-824.

Abstract

Background: The main purposes of this meta-analysis are to update the information about the impact of coronavirus disease 2019 (COVID-19) pandemic on outcomes of in-hospital cardiac arrest (IHCA) and to investigate the impact of being infected by by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) on IHCA outcomes.
Methods: The current meta-analysis is an update and follows the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Results: In analyses, pre- and intra-COVID-19 periods were observed for: shockable rhythms in 17.6% vs. 16.2% (odds ratio [OR]: 1.11; 95% confidence interval [CI]: 0.71–1.72; p = 0.65), return of spontaneous circulation (ROSC) in 47.4% vs. 44.0% (OR: 1.36; 95% CI: 0.90–2.07; p = 0.15), 30-day mortality in 59.8% vs. 60.9% (OR: 0.95; 95% CI: 0.75–1.22; p = 0.69) and overall mortality 75.8% vs. 74.7% (OR: 0.80; 95% CI: 0.49–1.28; p = 0.35), respectively. In analyses, SARS-CoV-2 positive and negative patients were observed for: shockable rhythms in 9.6% vs. 19.8% (OR: 0.51; 95% CI: 0.35–0.73; p < 0.001), ROSC in 33.9% vs. 52.1% (OR: 0.47; 95% CI: 0.30–0.73; p < 0.001), 30-day mortality in 77.2% vs. 59.7% (OR: 2.08; 95% CI: 1.28–3.38; p = 0.003) and overall mortality in 94.9% vs. 76.7% (OR: 3.20; 95% CI: 0.98–10.49; p = 0.05), respectively.
Conclusions: Despite ROSC, 30-day and overall mortality rate were not statistically different in pre- vs. intra-COVID-19 periods, a lower incidence of ROSC and higher 20-day mortality rate were observed in SARS-CoV-2 (+) compared to SARS-CoV-2 (–) patients.

Article available in PDF format

View PDF Download PDF file

References

  1. Rodriguez-Morales AJ, Bonilla-Aldana DK, Balbin-Ramon GJ, et al. History is repeating itself: Probable zoonotic spillover as the cause of the 2019 novel Coronavirus Epidemic. Infez Med. 2020; 28(1): 3–5.
  2. Dzieciatkowski T, Szarpak L, Filipiak KJ, et al. COVID-19 challenge for modern medicine. Cardiol J. 2020; 27(2): 175–183.
  3. Attila K, Ludwin K, Evrin T, et al. The impact of COVID-19 on airway management in prehospital resuscitation. Dis Emerg Med J. 2020; 5(4): 216–217.
  4. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020; 20(5): 533–534.
  5. Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(24): 759–765.
  6. Li G, Saguner A, An J, et al. Cardiovascular disease during the COVID-19 pandemic: Think ahead, protect hearts, reduce mortality. Cardiol J. 2020; 27(5): 616–624.
  7. Kulak K, Wieczorek K, Krupski A, et al. SARS-CoV-2 as a real threat for healthcare workers. Dis Emerg Med J. 2020.
  8. Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020; 8(5): 475–481.
  9. Ruetzler K, Szarpak L, Filipiak K, et al. The COVID-19 pandemic — a view of the current state of the problem. Dis Emerg Med J. 2020.
  10. Kowalik MM, Trzonkowski P, Łasińska-Kowara M, et al. COVID-19 — Toward a comprehensive understanding of the disease. Cardiol J. 2020; 27(2): 99–114.
  11. Tajbakhsh A, Gheibi Hayat SM, Taghizadeh H, et al. COVID-19 and cardiac injury: clinical manifestations, biomarkers, mechanisms, diagnosis, treatment, and follow up. Expert Rev Anti Infect Ther. 2021; 19(3): 345–357.
  12. Wańha W, Wybraniec M, Kapłon-Cieślicka A, et al. Myocardial infarction in the shadow of COVID-19. Cardiol J. 2020; 27(5): 478–480.
  13. Sip M, Puslecki M, Dabrowski M, et al. Implementation of extended cardiopulmonary resuscitation procedure in in-hospital cardiac arrest: a preliminary simulated study. Dis Emerg Med J. 2021; 6(1): 10–20.
  14. Lorente-Ros A, Monteagudo Ruiz JM, Rincón LM, et al. Myocardial injury determination improves risk stratification and predicts mortality in COVID-19 patients. Cardiol J. 2020; 27(5): 489–496.
  15. Fan L, Jiang S, Yang X, et al. COVID-19 drug treatment in China. Curr Pharmacol Rep. 2020 [Epub ahead of print]: 1–9.
  16. Khuroo MS, Khuroo M, Khuroo MS, et al. COVID-19 vaccines: a race against time in the middle of death and devastation! J Clin Exp Hepatol. 2020; 10(6): 610–621.
  17. Gozhenko A, Szrpk L, Jguszewski MJ. COVID-19 vccine — third dose, booster dose? Wht is it nd is it necessry? Dis Emerg Med J. 2021.
  18. Shao F, Xu S, Ma X, et al. In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China. Resuscitation. 2020; 151: 18–23.
  19. Armstrong RA, Kane AD, Kursumovic E, et al. Mortality in patients admitted to intensive care with COVID-19: an updated systematic review and meta-analysis of observational studies. Anaesthesia. 2021; 76(4): 537–548.
  20. Szarpak L, Borkowska M, Peacock FW, et al. Characteristics and outcomes of in-hospital cardiac arrest in COVID-19. A systematic review and meta-analysis. Cardiol J. 2021; 28(4): 503–508.
  21. Borkowska MJ, Smereka J, Safiejko K, et al. Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study. Cardiol J. 2021; 28(1): 15–22.
  22. Lim D, Park SYi, Choi B, et al. The comparison of emergency medical service responses to and outcomes of out-of-hospital cardiac arrest before and during the COVID-19 pandemic in an area of Korea. J Korean Med Sci. 2021; 36(36): e255.
  23. Ludwin K, Bialka S, Czyzewski L, et al. Video laryngoscopy for endotracheal intubation of adult patients with suspected/ confirmed COVID-19. A systematic review and meta-analysis of randomized controlled trials. Dis Emerg Med J. 2020.
  24. Szarpak L, Ruetzler K, Dabrowski M, et al. Dilemmas in resuscitation of COVID-19 patients based on current evidence. Cardiol J. 2020; 27(3): 327–328.
  25. Małysz M, Smereka J, Jaguszewski M, et al. An optimal chest compression technique using personal protective equipment during resuscitation in the COVID-19 pandemic: a randomized crossover simulation study. Kardiol Pol. 2020; 78(12): 1254–1261.
  26. Malysz M, Dabrowski M, Böttiger BW, et al. Resuscitation of the patient with suspected/confirmed COVID-19 when wearing personal protective equipment: A randomized multicenter crossover simulation trial. Cardiol J. 2020; 27(5): 497–506.
  27. Malysz M, Jaguszewski M, Szarpak L, et al. Comparison of different chest compression positions for use while wearing CBRN-PPE: a randomized crossover simulation trial. Dis Emerg Med J. 2020.
  28. Bhatnagar A, Khraishah H, Lee J, et al. Rapid implementation of a mechanical chest compression device for in-hospital cardiac arrest during the COVID-19 pandemic. Resuscitation. 2020; 156: 4–5.
  29. Page MJ, McKenzie JE, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021; 372: n160.
  30. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005; 5: 13.
  31. Ades AE, Lu G, Higgins J. The interpretation of random-effects meta-analysis in decision models. Med Decis Making. 2016; 25(6): 646–654.
  32. Lyu T, Khan F, Sajeed S, et al. In-hospital cardiac arrest incidence and outcomes in the era of COVID-19: an observational study in a Singapore hospital. Int J Emerg Med. 2021; 14(1): 33.
  33. Aldabagh M, Wagle S, Cesa M, et al. Survival of In-Hospital Cardiac Arrest in COVID-19 Infected Patients. Healthcare (Basel). 2021; 9(10).
  34. Miles JA, Mejia M, Rios S, et al. Characteristics and outcomes of in-hospital cardiac arrest events during the COVID-19 pandemic: a single-center experience from a new york city public hospital. Circ Cardiovasc Qual Outcomes. 2020; 13(11): e007303.
  35. Roedl K, Söffker G, Fischer D, et al. Effects of COVID-19 on in-hospital cardiac arrest: incidence, causes, and outcome - a retrospective cohort study. Scand J Trauma Resusc Emerg Med. 2021; 29(1): 30.
  36. Sultanian P, Lundgren P, Strömsöe A, et al. Cardiac arrest in COVID-19: characteristics and outcomes of in- and out-of-hospital cardiac arrest. A report from the Swedish Registry for Cardiopulmonary Resuscitation. Eur Heart J. 2021; 42(11): 1094–1106.
  37. Tong SKi, Ling L, Zhang JZ, et al. Effect of the COVID-19 pandemic on cardiac arrest resuscitation practices and outcomes in non-COVID-19 patients. J Intensive Care. 2021; 9(1): 55.
  38. Yuriditsky E, Mitchell OJL, Brosnahan SB, et al. Clinical characteristics and outcomes of in-hospital cardiac arrest among patients with and without COVID-19. Resusc Plus. 2020; 4: 100054.